Infertility

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    A Reproductive Endocrinology, answered on behalf of
    What is preimplantation genetic screening (PGS)?
    Preimplantation genetic screening (PGS) checks the embryo to make sure it has a healthy number of chromosomes. Watch reproductive endocrinologist Noel Peng, MD, of Medical City Dallas Hospital, explain how this determines chances for pregnancy.
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    Why would I freeze my eggs?
    If you're not ready to get pregnant now, freezing your eggs is one way to preserve your fertility, says reproductive endocrinologist Noel Peng, MD, of Medical City Dallas Hospital. In this video, he gives examples of people who use this option.
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    There are many resources for cancer patients who are facing sterility. A good starting point may be to talk to your oncologist or cancer treatment specialist.

    If you are a man, your doctor may refer you to an urologist. This is a doctor who specializes in the urinary tract.

    Women may be sent to a gynecologist. This type of doctor specializes in the female reproductive organs.

    These doctors can determine if you're a good candidate for having your sperm or eggs saved before cancer treatment to help you have children in the future. They can also discuss other ways for you to have a successful future pregnancy. For example, an option for women may be a surrogate mother. This person carry the baby in their womb when you can't.
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    How can radiation affect fertility?
    Radiation can affect fertility in a couple of ways. In this video, Tamara Sutton, director of cancer services at Los Robles Hospital & Medical Center, explains the risks of radiation treatment. 
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    Superovulation is the use of fertility drugs to cause an ovary to release two or more eggs in one cycle rather than one egg, as is usual for a typical menstrual cycle. Superovulation is often used in combination with other fertility treatments, such as in vitro fertilization and intrauterine insemination, to increase a woman's chances of becoming pregnant successfully. This combination of treatments may be recommended for women who have unexplained infertility or endometriosis. Superovulation is also called controlled ovarian stimulation.
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    Fertility awareness is a method a woman can use to determine when she is most likely to ovulate, and is therefore most likely to become pregnant. She can then use this method either to prevent pregnancy by avoiding sexual intercourse during her most fertile days, or to increase her odds of becoming pregnant by making sure to have sexual intercourse during those fertile days.
     
    There are several methods for determining your most fertile time of month.
    • The Temperature Method. A woman's body temperature rises slightly each month right at the time of ovulation. By taking her temperature every day first thing in the morning, she can detect this rise and know about the time her ovary is releasing an egg.
    • Cervical Mucus Method. Around the time of ovulation, a woman's cervical mucus increases and also becomes clear and slippery, the consistency of a raw egg white, making it easier for sperm to swim through to reach and fertilize an egg. By monitoring the changes in her cervical mucus, she can identify this fertile time.
    • The Calendar Method and/or "standard days" method both involve keeping track of menstrual cycles on a calendar and identifying how long they are, then determining which days are fertile days and avoiding intercourse during those days.
    If used correctly for pregnancy prevention, fertility awareness methods can be as much as 95 to 97 percent effective. However, about 25 percent of women who don't use fertility awareness methods correctly all the time will become pregnant. Women who have irregular menstrual cycles may be at particularly high risk of unplanned pregnancy while using fertility awareness methods. Also, fertility awareness methods do not protect against sexually transmitted diseases.
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    A postcoital test is a medical examination done as part of an infertility workup, to try to determine the cause of a couple's difficulty in becoming pregnant. In a postcoital test, a doctor takes a sample of a woman's cervical mucus within 12 hours after she has sexual intercourse. The doctor then views the sample under a microscope to see if there are sperm cells present and if they are moving normally.

    The timing of a postcoital test is important. It is best to do a postcoital test one to two days before ovulation, when the cervical mucus is thin and stretchy and it is easiest for sperm to swim through it up to the uterus, and eventually to reach the egg. Determining the best time to have a postcoital test can require some vigilance by the woman to take her basal body temperature first thing in the morning, examine her own cervical mucus for signs that ovulation is near and possibly to use an at-home ovulation predictor kit.

    When a postcoital test is timed correctly, a normal result on a postcoital test should mean that a normal number of sperm are present and they are moving forward, the cervical mucus can stretch to two inches or more and when mucus dries, it dries in a fernlike pattern.

    The postcoital test is not used as often as in the past; it is difficult to time correctly, is not considered very reliable and is thus seldom prescribed.
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    How can acupuncture and Chinese medicine help treat infertility?
    Acupuncture and Chinese medicine can help treat infertility, according to Anish Shah, MD, a reproductive endocrinologist at Richmond Center for Fertility and Endocrinology. In this video, he explains how doctors can coordinate these treatments.
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    There is no way to prevent infertility because there are many factors that contribute to a woman's ability to ovulate, conceive and carry a pregnancy to term. Likewise, your male partner also has numerous factors -- natural and environmental -- that can contribute to infertility. The condition is not exclusively a woman's problem. About one-third of infertility cases involve male factor problems alone, and approximately one-third involve problems with both partners.

    For women, risk factors that could lead to infertility include:
    • being very overweight or very thin, either of which can affect ovulation and fertility
    • chronic, debilitating diseases, such as unregulated diabetes, lupus or thyroid problems that can interfere with normal ovarian function
    • medications such as high-dose steroids that can interrupt ovulation
    • polycystic ovarian syndrome (PCOS), with symptoms including irregular or infrequent periods, excessive facial hair and acne
    • surgeries on the cervix or abnormal Pap smears that result in cryosurgery or cone biopsy, which can affect the function of the cervix.
    • hormonal imbalances that cause abnormalities in your menstrual cycles
    • multiple miscarriages (two or more early pregnancy losses)
    • environmental factors, such as cigarette smoking, alcohol consumption, illegal drugs and exposure to workplace hazards or toxins
    • medication including herbal or natural medication
    • age
    • sexually transmitted diseases (STDs)
    • fallopian tube disease (accounts for about 22% of infertility cases)
    • endometriosis
    If you have a chronic health condition, be sure to discuss it with your healthcare professional. Most women with chronic conditions can become pregnant, have a healthy pregnancy and deliver a healthy baby.
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    Learning about different surrogacy agencies and deciding which one you would like to work with can be overwhelming. Every agency's approach is different, so it's important to choose a qualified agency that fits your personal requirements and expectations.

    Consider how the agency prescreens its potential surrogate mothers and whether its services and support offering is comprehensive. Understand how it will manage insurance coverage and financial transactions, facilitate legal representation and how much the agency will charge in fees.

    Your fertility clinic or a previous intended parent may be able to provide referrals for reputable agencies.